|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
OP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$646.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$393.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$476.96
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$473.77
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$732.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$732.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$732.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: InnovAge PACE Commercial |
$430.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.98
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: Riverside University Health System MISP |
$344.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$732.19
|
| Rate for Payer: Vantage Medical Group Senior |
$732.19
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
IP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$473.77
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
IP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$473.77
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
|
|
HC KIT CATH CNTRL VNS 5FR TL
|
Facility
|
OP
|
$861.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$775.26 |
| Rate for Payer: Adventist Health Commercial |
$172.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$646.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$393.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$476.96
|
| Rate for Payer: Blue Shield of California Commercial |
$665.86
|
| Rate for Payer: Blue Shield of California EPN |
$434.15
|
| Rate for Payer: Cash Price |
$473.77
|
| Rate for Payer: Central Health Plan Commercial |
$689.12
|
| Rate for Payer: Cigna of CA HMO |
$602.98
|
| Rate for Payer: Cigna of CA PPO |
$602.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$732.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$732.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$732.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.56
|
| Rate for Payer: EPIC Health Plan Senior |
$344.56
|
| Rate for Payer: Galaxy Health WC |
$732.19
|
| Rate for Payer: Global Benefits Group Commercial |
$516.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.26
|
| Rate for Payer: InnovAge PACE Commercial |
$430.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.98
|
| Rate for Payer: Multiplan Commercial |
$646.05
|
| Rate for Payer: Networks By Design Commercial |
$430.70
|
| Rate for Payer: Prime Health Services Commercial |
$732.19
|
| Rate for Payer: Riverside University Health System MISP |
$344.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$323.28
|
| Rate for Payer: United Healthcare All Other HMO |
$314.67
|
| Rate for Payer: United Healthcare HMO Rider |
$307.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$282.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$732.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$732.19
|
| Rate for Payer: Vantage Medical Group Senior |
$732.19
|
|
|
HC KIT CATH FEMALE 8FR
|
Facility
|
IP
|
$16.15
|
|
| Hospital Charge Code |
901698693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$14.54 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$8.88
|
| Rate for Payer: Central Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Multiplan Commercial |
$12.11
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
|
|
HC KIT CATH FEMALE 8FR
|
Facility
|
OP
|
$16.15
|
|
| Hospital Charge Code |
901698693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$14.54 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.48
|
| Rate for Payer: Blue Shield of California Commercial |
$9.87
|
| Rate for Payer: Blue Shield of California EPN |
$6.44
|
| Rate for Payer: Cash Price |
$8.88
|
| Rate for Payer: Central Health Plan Commercial |
$12.92
|
| Rate for Payer: Cigna of CA HMO |
$10.34
|
| Rate for Payer: Cigna of CA PPO |
$11.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.54
|
| Rate for Payer: InnovAge PACE Commercial |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.30
|
| Rate for Payer: Multiplan Commercial |
$12.11
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
| Rate for Payer: Riverside University Health System MISP |
$6.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.07
|
| Rate for Payer: United Healthcare All Other HMO |
$8.07
|
| Rate for Payer: United Healthcare HMO Rider |
$8.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$315.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.64
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$380.08
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: InnovAge PACE Commercial |
$345.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$483.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX16CM
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$380.08
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$315.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.64
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$380.08
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: InnovAge PACE Commercial |
$345.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$483.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX20CM
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698357
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$380.08
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
|
OP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$380.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$518.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$315.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.64
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$380.08
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$587.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$587.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: InnovAge PACE Commercial |
$345.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$483.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$483.74
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: Riverside University Health System MISP |
$276.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$587.40
|
| Rate for Payer: Vantage Medical Group Senior |
$587.40
|
|
|
HC KIT CATH HEMO 2LUMEN 12FRX25CM
|
Facility
|
IP
|
$691.06
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.21 |
| Max. Negotiated Rate |
$621.95 |
| Rate for Payer: Adventist Health Commercial |
$138.21
|
| Rate for Payer: Blue Shield of California Commercial |
$534.19
|
| Rate for Payer: Blue Shield of California EPN |
$348.29
|
| Rate for Payer: Cash Price |
$380.08
|
| Rate for Payer: Central Health Plan Commercial |
$552.85
|
| Rate for Payer: Cigna of CA HMO |
$483.74
|
| Rate for Payer: Cigna of CA PPO |
$483.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.42
|
| Rate for Payer: EPIC Health Plan Senior |
$276.42
|
| Rate for Payer: Galaxy Health WC |
$587.40
|
| Rate for Payer: Global Benefits Group Commercial |
$414.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$427.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.21
|
| Rate for Payer: Multiplan Commercial |
$518.29
|
| Rate for Payer: Networks By Design Commercial |
$345.53
|
| Rate for Payer: Prime Health Services Commercial |
$587.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$259.35
|
| Rate for Payer: United Healthcare All Other HMO |
$252.44
|
| Rate for Payer: United Healthcare HMO Rider |
$246.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$226.32
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX16CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX16CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$526.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$388.39
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: InnovAge PACE Commercial |
$350.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$491.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$491.01
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health System MISP |
$280.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$420.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$420.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX20CM
|
Facility
|
IP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
|
|
HC KIT CATH HEMO 3LUMEN 12FRX20CM
|
Facility
|
OP
|
$701.45
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.29 |
| Max. Negotiated Rate |
$631.30 |
| Rate for Payer: Adventist Health Commercial |
$140.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$385.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$526.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$320.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$388.39
|
| Rate for Payer: Blue Shield of California Commercial |
$542.22
|
| Rate for Payer: Blue Shield of California EPN |
$353.53
|
| Rate for Payer: Cash Price |
$385.80
|
| Rate for Payer: Central Health Plan Commercial |
$561.16
|
| Rate for Payer: Cigna of CA HMO |
$491.01
|
| Rate for Payer: Cigna of CA PPO |
$491.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$596.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$596.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$280.58
|
| Rate for Payer: EPIC Health Plan Senior |
$280.58
|
| Rate for Payer: Galaxy Health WC |
$596.23
|
| Rate for Payer: Global Benefits Group Commercial |
$420.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$631.30
|
| Rate for Payer: InnovAge PACE Commercial |
$350.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$467.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$267.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$434.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$491.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$491.01
|
| Rate for Payer: Multiplan Commercial |
$526.09
|
| Rate for Payer: Networks By Design Commercial |
$350.73
|
| Rate for Payer: Prime Health Services Commercial |
$596.23
|
| Rate for Payer: Riverside University Health System MISP |
$280.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$420.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$420.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.25
|
| Rate for Payer: United Healthcare All Other HMO |
$256.24
|
| Rate for Payer: United Healthcare HMO Rider |
$250.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$596.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.23
|
| Rate for Payer: Vantage Medical Group Senior |
$596.23
|
|
|
HC KIT CATH HEMO NGRA 12FR 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CATH HEMO NGRA 12FR 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CATH HEMO NGRA DL 12FR20C
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC KIT CATH HEMO NGRA DL 12FR20C
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.15
|
| Rate for Payer: Blue Shield of California Commercial |
$448.34
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: InnovAge PACE Commercial |
$290.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC KIT CATH HEMO NGRA DL 12FR24C
|
Facility
|
IP
|
$830.30
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.06 |
| Max. Negotiated Rate |
$747.27 |
| Rate for Payer: Adventist Health Commercial |
$166.06
|
| Rate for Payer: Cash Price |
$456.66
|
| Rate for Payer: Central Health Plan Commercial |
$664.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.12
|
| Rate for Payer: EPIC Health Plan Senior |
$332.12
|
| Rate for Payer: Galaxy Health WC |
$705.75
|
| Rate for Payer: Global Benefits Group Commercial |
$498.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$513.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.06
|
| Rate for Payer: Multiplan Commercial |
$622.73
|
| Rate for Payer: Networks By Design Commercial |
$539.70
|
| Rate for Payer: Prime Health Services Commercial |
$705.75
|
|
|
HC KIT CATH HEMO NGRA DL 12FR24C
|
Facility
|
OP
|
$830.30
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901605111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.06 |
| Max. Negotiated Rate |
$747.27 |
| Rate for Payer: Adventist Health Commercial |
$166.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$504.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$705.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$456.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$622.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$402.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$487.64
|
| Rate for Payer: Blue Shield of California Commercial |
$507.31
|
| Rate for Payer: Blue Shield of California EPN |
$331.29
|
| Rate for Payer: Cash Price |
$456.66
|
| Rate for Payer: Central Health Plan Commercial |
$664.24
|
| Rate for Payer: Cigna of CA HMO |
$531.39
|
| Rate for Payer: Cigna of CA PPO |
$614.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$705.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$705.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$705.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.12
|
| Rate for Payer: EPIC Health Plan Senior |
$332.12
|
| Rate for Payer: Galaxy Health WC |
$705.75
|
| Rate for Payer: Global Benefits Group Commercial |
$498.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.27
|
| Rate for Payer: InnovAge PACE Commercial |
$415.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$553.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$316.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$513.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$581.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$581.21
|
| Rate for Payer: Multiplan Commercial |
$622.73
|
| Rate for Payer: Networks By Design Commercial |
$539.70
|
| Rate for Payer: Prime Health Services Commercial |
$705.75
|
| Rate for Payer: Riverside University Health System MISP |
$332.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$498.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$498.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$415.15
|
| Rate for Payer: United Healthcare All Other HMO |
$415.15
|
| Rate for Payer: United Healthcare HMO Rider |
$415.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$415.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$705.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$705.75
|
| Rate for Payer: Vantage Medical Group Senior |
$705.75
|
|
|
HC KIT CATH HICKMAN RPR 10FR
|
Facility
|
OP
|
$1,384.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.92 |
| Max. Negotiated Rate |
$1,246.14 |
| Rate for Payer: Adventist Health Commercial |
$276.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,176.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$761.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,038.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$632.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$766.65
|
| Rate for Payer: Blue Shield of California Commercial |
$1,070.30
|
| Rate for Payer: Blue Shield of California EPN |
$697.84
|
| Rate for Payer: Cash Price |
$761.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,107.68
|
| Rate for Payer: Cigna of CA HMO |
$969.22
|
| Rate for Payer: Cigna of CA PPO |
$969.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,176.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,176.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,176.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.84
|
| Rate for Payer: EPIC Health Plan Senior |
$553.84
|
| Rate for Payer: Galaxy Health WC |
$1,176.91
|
| Rate for Payer: Global Benefits Group Commercial |
$830.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,246.14
|
| Rate for Payer: InnovAge PACE Commercial |
$692.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$923.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$527.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$857.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$969.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$969.22
|
| Rate for Payer: Multiplan Commercial |
$1,038.45
|
| Rate for Payer: Networks By Design Commercial |
$692.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,176.91
|
| Rate for Payer: Riverside University Health System MISP |
$553.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$830.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$830.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$519.64
|
| Rate for Payer: United Healthcare All Other HMO |
$505.79
|
| Rate for Payer: United Healthcare HMO Rider |
$494.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$453.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,176.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,176.91
|
| Rate for Payer: Vantage Medical Group Senior |
$1,176.91
|
|
|
HC KIT CATH HICKMAN RPR 10FR
|
Facility
|
IP
|
$1,384.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.92 |
| Max. Negotiated Rate |
$1,246.14 |
| Rate for Payer: Adventist Health Commercial |
$276.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1,070.30
|
| Rate for Payer: Blue Shield of California EPN |
$697.84
|
| Rate for Payer: Cash Price |
$761.53
|
| Rate for Payer: Central Health Plan Commercial |
$1,107.68
|
| Rate for Payer: Cigna of CA HMO |
$969.22
|
| Rate for Payer: Cigna of CA PPO |
$969.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.84
|
| Rate for Payer: EPIC Health Plan Senior |
$553.84
|
| Rate for Payer: Galaxy Health WC |
$1,176.91
|
| Rate for Payer: Global Benefits Group Commercial |
$830.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,246.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$923.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$527.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$857.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.92
|
| Rate for Payer: Multiplan Commercial |
$1,038.45
|
| Rate for Payer: Networks By Design Commercial |
$692.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,176.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$519.64
|
| Rate for Payer: United Healthcare All Other HMO |
$505.79
|
| Rate for Payer: United Healthcare HMO Rider |
$494.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$453.46
|
|
|
HC KIT CATH HICKMAN RPR 12FR
|
Facility
|
OP
|
$2,636.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$527.28 |
| Max. Negotiated Rate |
$2,372.76 |
| Rate for Payer: Adventist Health Commercial |
$527.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,240.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,450.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,977.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,203.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,459.77
|
| Rate for Payer: Blue Shield of California Commercial |
$2,037.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,328.75
|
| Rate for Payer: Cash Price |
$1,450.02
|
| Rate for Payer: Central Health Plan Commercial |
$2,109.12
|
| Rate for Payer: Cigna of CA HMO |
$1,845.48
|
| Rate for Payer: Cigna of CA PPO |
$1,845.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,240.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,240.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,240.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,054.56
|
| Rate for Payer: EPIC Health Plan Senior |
$1,054.56
|
| Rate for Payer: Galaxy Health WC |
$2,240.94
|
| Rate for Payer: Global Benefits Group Commercial |
$1,581.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,372.76
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,758.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,004.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,631.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$527.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,845.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,845.48
|
| Rate for Payer: Multiplan Commercial |
$1,977.30
|
| Rate for Payer: Networks By Design Commercial |
$1,318.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,240.94
|
| Rate for Payer: Riverside University Health System MISP |
$1,054.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,581.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,581.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.44
|
| Rate for Payer: United Healthcare All Other HMO |
$963.08
|
| Rate for Payer: United Healthcare HMO Rider |
$942.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$863.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,240.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,240.94
|
| Rate for Payer: Vantage Medical Group Senior |
$2,240.94
|
|
